Abstract
The mesorectal fascia (MRF), or visceral layer of the endopelvic fascia, encircles the rectum and the mesorectal fat, nodes, and lymphatic vessels to form a distinct anatomic unit, called the mesorectum. The MRF runs along the anterior aspect of the sacrum, where it fuses with the presacral fascia, and then laterally on either side of the rectum. Anteriorly in males, it forms a dense band of connective tissue posterior to the seminal vesicle and prostate gland called the Denonvilliers’ fascia [1].
References
Kaur H, Choi H, You YN et al (2012) MR imaging for preoperative evaluation of primary rectal cancer: practical considerations. Radiographics 32(2):389–409
Quirke P, Durdey P, Dixon MF et al (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection: histopathological study of lateral tumour spread and surgical excision. Lancet 2:996–999
Nagtegaal ID, Quirke P (2008) What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 26:303–312
Sebag-Montefiore D, Stephens RJ, Steele R et al (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373:811–820
Glimelius B, Beets-Tan R, Blomqvist L et al (2011) Mesorectal fascia instead of circumferential resection margin in preoperative staging of rectal cancer. J Clin Oncol 29(16):2142–2143
Vliegen R, Dresen R, Beets G et al (2008) The accuracy of multidetector row CT for the assessment of tumor invasion of the mesorectal fascia in primary rectal cancer. Abdom Imaging 33(5):604–610
Beets-Tan RG, Lambregts DM, Maas M et al (2013) Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol 23(9):2522–2531
MERCURY Study Group (2006) Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ 333(7572):779
Span MM, Wiggers T (2009) Multislice CT as a primary screening tool for the prediction of an involved mesorectal fascia and distant metastases in primary rectal cancer: a multicenter study. Dis Colon Rectum 52(5):928–934
Beets-Tan RG, Beets GL (2004) Rectal cancer: review with emphasis on MR imaging. Radiology 232:335–346
Beets-Tan RG, Beets GL, Vliegen RF et al (2001) Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet 357(9255):497–504
Barbaro B, Fiorucci C, Tebala C et al (2009) Locally advanced rectal cancer: MR imaging in prediction of response after preoperative chemotherapy and radiation therapy. Radiology 250(3):730–739
Barbaro B, Vitale R, Leccisotti L et al (2010) Restaging locally advanced rectal cancer with MR imaging after chemoradiation therapy. Radiographics 30(3):699–716
Barbaro B, Vitale R, Valentini V et al (2012) Diffusion-weighted magnetic resonance imaging in monitoring rectal cancer response to neoadjuvant chemoradiotherapy. Int J Radiat Oncol Biol Phys 83(2):594–599
Park MJ, Kim SH, Lee SJ, Jang KM, Rhim H (2011) Locally advanced rectal cancer: added value of diffusion-weighted MR imaging for predicting tumor clearance of the mesorectal fascia after neoadjuvant chemotherapy and radiation therapy. Radiology 260(3):771–780
Lambregts DM, Vandecaveye V, Barbaro B et al (2011) Diffusion-weighted MRI for selection of complete responders after chemoradiation for locally advanced rectal cancer: a multicenter study. Ann Surg Oncol 18(8):2224–2231
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Barbaro, B. (2018). How Can We Better Identify Mesorectal Fascia Involvement?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_10
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